Application for Individuals
Hard Hats for Christ
P.O. Box 636 Kelso, WA 98626 USA
information@hh4c.org

Application Date ( Please enter today's date - mm/dd/yyyy )

PERSONAL INFORMATION:

Self

Title
First Name
Middle
Last Name
Suffix
Nickname	if different than first

Gender
Birth Date	a complete date please

Occupation:

Spouse

Title
First Name
Middle
Last Name	if different
Suffix
Nickname	if different than first

Gender
Birth Date	a complete date please

Occupation:

Marital Status Anniversary Date enter a complete date please

Denomination ( Optional )

Contact Addresses

Primary	street address
	second line - usually blank
City	State ZIP/Post-Code
Country	(if not USA)

Second	street address
	second line - usually blank
City	State ZIP/Post-Code
Country	(if not USA)

Third	street address
	second line - usually blank
City	State ZIP/Post-Code
Country	(if not USA) Please indicate seasonal time periods in the Address Notes.

Address Notes:
Contact Preference ( Select the manner or method by which you prefer for MBI to contact you. )

Phones, Email-Addresses, Web-Site-URLs

Phone Notes:

EXPECTATIONS and BACKGROUND

How did you first hear of Hard Hats for Christ?

What reasons most influenced your decision to apply?

What expectations do you have as a Hard Hats volunteer?

Prior Hard Hats for Christ experience ( what / when / where ) ?

Please tell us your Personal Testimony:

Other missions experience ( what / when / where ) ?

Are you interested in being an Hard Hats project team leader? Yes

Self -- Languages

	Proficiency = Native

Spouse -- Languages

	Proficiency = Native

Language Notes:

List Children and other Dependents who will accompany you:
Name    Birth date      Gender        Relationship
Name    Birth date      Gender        Relationship
Name    Birth date      Gender        Relationship
Name    Birth date      Gender        Relationship
Name    Birth date      Gender        Relationship
Name    Birth date      Gender        Relationship

Dependent Notes:

EMERGENCY CONTACT INFORMATION

Contact - Title
First Name		Nick Name if different than first
Middle Name
Last Name
Suffix		Gender

Address
	street address
	second line - usually blank
City	State ZIP/Post-Code
Country	(if not USA)

Phones and Email-Addresses




Emergency Contact Notes:

STATEMENT OF FAITH

Trusting in Jesus Christ as my Savior, and in full agreement with the Hard Hats for Christ Statement of Faith, I believe:

that the Bible is the inspired and authoritative Word of the one true God, who exists eternally in three persons: Father, Son, and Holy Spirit;
that all men and women are fallen and need to be regenerated by the Holy Spirit for salvation, which is a gift of God by grace through faith alone, apart from works;
that Jesus Christ is God, was born of a virgin, died in my place on the cross, rose bodily and ascended to heaven, and will return one day from there for His bride, the Church;
that the saved will be raised to everlasting life with Christ in Heaven, and that the unsaved will be raised to everlasting punishment, separated from God in Hell;
that Jesus Christ commands His followers to spread the Gospel throughout the world by their words and their deeds.

I/We have read the Vision, Mission, Values Statements and the Statement of Faith. I/We believe and accept them in being considered for service. If accepted, I/We will abide by the spirit and guidelines of Hard Hats for Christ and the applicable project.

Signature: (By filling in your name, you in essence sign, indicating your agreement.)
Date:

Spouse’s Signature:
Date:

RELEASE FROM LIABILITY

I/We hereby agree to hold harmless, and release from any liability, Hard Hats for Christ and applicable project, its agents, employees and volunteer assistants, from any liability whatsoever arising out of any injury, damage or loss which may be sustained during my/our time of involvement with Hard Hats for Christ. I/we state that I/we knowingly waive any and all rights to initiate any action before any court of law or equity against Hard Hats for Christ relating to my/our voluntary choice to be involved with Hard Hats for Christ.

Applicant’s Signature:
Date:

Spouse’s Signature:
Date:

If applicant is under 18 years of age, signature of parent or responsible party is also required.

Signature: Date:

(By filling in your name, you in essence sign, indicating your agreement.)

THANK YOU for taking the time to fill in all the above information -- it helps us serve you.

After you "Submit" the form, you will see a "form confirmation" window -- simply close it.

Application for Individuals Hard Hats for Christ P.O. Box 636 Kelso, WA 98626 USA information@hh4c.org

REFERENCE INFORMATION

Application for Individuals
Hard Hats for Christ
P.O. Box 636 Kelso, WA 98626 USA
information@hh4c.org